Idaho Statutes

Idaho Statutes are updated to the web July 1 following the legislative session.

pecnv.out

TITLE 41
INSURANCE
CHAPTER 41
JOINT PUBLIC AGENCY SELF-FUNDED HEALTH CARE PLANS
41-4102.  Definitions. As used in this chapter:
(1)  "Administrator" means a person, other than a board member, employed by the board to administer a joint public agency self-funded plan.
(2)  "Beneficiary" means any individual entitled, under the joint public agency self-funded plan, to payment by the trust fund of any part of all of the cost of any health care service rendered to him.
(3)  "Board of trustees" or "board" is the board of trustees of the trust fund.
(4)  "Contribution" means the amount paid or payable by the employer or employee into the trust fund.
(5)  "Director" means the director of the department of insurance of this state.
(6)  "Joint powers agreement" means an agreement entered into between public agencies pursuant to chapter 23, title 67, Idaho Code.
(7)  "Joint public agency self-funded plan" or "self-funded plan" or "plan" means any public agency plan established by a joint powers agreement and under which payment for any disability benefits not otherwise provided for under title 72, Idaho Code (worker’s compensation and related laws — industrial commission), medical, surgical, hospital, and other services for prevention, diagnosis, or treatment of any disease, injury, or bodily condition of an employee is, or is to be, regularly provided for or promised from funds created or maintained in whole or in part by contributions or payments thereto by a public agency employer, or by a public agency employer and the employees of the public agency, and not otherwise covered by insurance or contract with a health care service corporation, health maintenance organization, or similar other third party prepayment plan.
(8)  "Person" means any individual, corporation, association, firm, syndicate, organization or other entity.
(9)  "Public agency" means any city, county or political subdivision of this state, including, but not limited to: counties; school districts; highway districts; port authorities; instrumentalities of counties, county hospitals, cities or any political subdivision created under the laws of the state of Idaho; and the state of Idaho and any agency of the state government. "Public agency" also means any group of more than one (1) of the above public agencies acting together pursuant to a joint powers agreement in accordance with chapter 23, title 67, Idaho Code.
(10) "Surplus" means the excess of the assets of a self-funded plan minus the liabilities of the plan, provided the liabilities of a self-funded plan shall include the claims liability of the plan.
(11) "Trust fund" means a fund established under a joint public agency self-funded plan for receipt of contributions of employers and employees and payment of or with respect to health care service costs of beneficiaries.

History:
[41-4102, added 2006, ch. 415, sec. 1, p. 1272; am. 2018, ch. 61, sec. 1, p. 151.]


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